The aim of the proposed three-site study is to increase the rate of full remission from major depressive disorder (MDD) at the end of 16 weeks of treatment for people who experience both major depressive disorder and insomnia.

Possible antidepressants are sertraline, escitalopram, desvenlafaxine, based on past history, response and tolerance

Behavioral: Cognitive Behavioral Therapy for Insomnia

Detailed Description:

Participants with major depressive disorder and insomnia who meet all study criteria will receive state-of-the-art antidepressant medications and one of two insomnia therapies. The specific therapy for insomnia will be determined by chance (like a flip of a coin), with an equal chance to receive either cognitive-behavioral therapy for insomnia or desensitization psychotherapy for insomnia. The study physician will select an initial antidepressant medication from a list of three possible medications . If that medication is not helpful, another medication may be tried after 8 weeks or in the event of severe side effects.

Eligibility

Ages Eligible for Study:

18 Years to 75 Years

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

Meets criteria for Major Depressive Disorder

Between 18 and 75 years of age and adequately fluent in English

Meets criteria for an insomnia disorder

Exclusion Criteria:

Women who are currently pregnant, breast-feeding, or not using a reliable birth control method.

People for whom the antidepressant medication(s) provided in the study is not indicated

People who have had minimum adequate trials of (or have not been able to tolerate) all three study medications.

People with uncontrolled medical conditions.

People with moderate or severe sleep disorders other than insomnia

Individuals on a fixed night shift or rotating work schedule that requires a night shift.

Patients with a current principal diagnosis of a psychiatric disorder that necessitates treatment that is not offered in the study.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00767624